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Mirtazapine is a medication primarily used for the treatment of major depressive disorder.
While it can be an effective treatment for depression, like all medications, it comes with
potential side effects. In this article, we will explore the side effects of Mirtazapine in detail.
Lily's Story: Lily was prescribed Mirtazapine for her anxiety. She experienced an increase in
appetite and weight gain, but the medication also helped her manage her anxiety. However, Lily
noticed that she felt more irritable and had difficulty controlling her temper while taking
Mirtazapine. These side effects were distressing for Lily, and she eventually decided to switch to
a different medication to better manage her anxiety without these side effects.
1. Drowsiness
One of the most common side effects of Mirtazapine is drowsiness. This is because the
medication affects the brain's neurotransmitters, including serotonin and norepinephrine.
Patients may experience sleepiness, fatigue, or lethargy during the day, making it difficult to
focus or concentrate. Patients taking Mirtazapine should avoid driving or operating heavy
machinery until they know how the medication affects them.
2. Weight Gain
Weight gain is another common side effect of Mirtazapine. This is because the medication
increases appetite and can cause patients to crave carbohydrate-rich foods. Weight gain can be
particularly concerning for patients who are already overweight or obese, as it can increase the
risk of other health problems, such as diabetes and heart disease.
3. Dry Mouth
Mirtazapine can also cause dry mouth, which can be uncomfortable and may lead to other oral
health problems. Patients should drink plenty of water to help alleviate this side effect.
4. Dizziness
Dizziness is another common side effect of Mirtazapine. This is because the medication can
cause a drop in blood pressure, leading to lightheadedness or vertigo. Patients should avoid
sudden changes in position, such as standing up quickly, which can exacerbate dizziness.
5. Constipation
Mirtazapine can also cause constipation, which can be uncomfortable and may lead to other
health problems, such as hemorrhoids. Patients should eat a diet high in fiber and drink plenty
of water to help alleviate this side effect.
6. Headache
Some patients may experience headaches while taking Mirtazapine. This side effect is usually
mild and can be alleviated with over-the-counter pain relievers, such as ibuprofen or
acetaminophen.
7. Nausea and Vomiting
Mirtazapine can cause nausea and vomiting, particularly during the first few weeks of
treatment. Patients should take the medication with food to help alleviate this side effect.
8. Agitation and Irritability
In rare cases, Mirtazapine can cause agitation and irritability. Patients who experience these
symptoms should contact their healthcare provider immediately.
9. Sexual Dysfunction
Mirtazapine can also cause sexual dysfunction, including decreased libido, difficulty achieving
orgasm, and erectile dysfunction. Patients who experience these symptoms should talk to their
healthcare provider about alternative treatments.
10. Seizures
While rare, Mirtazapine can cause seizures in some patients, particularly those with a history of
epilepsy or other seizure disorders. Patients who experience seizures while taking Mirtazapine
should contact their healthcare provider immediately.
Jane's Story: Jane was prescribed Mirtazapine for her depression. She experienced severe
drowsiness and dry mouth after taking the medication. She struggled to stay awake during the
day and had difficulty concentrating at work. She also had trouble sleeping at night due to vivid
dreams and nightmares. Eventually, Jane had to stop taking Mirtazapine as the side effects were
too severe for her to manage.
11. Suicidal Thoughts or Actions
Like all antidepressants, Mirtazapine carries a warning for increased risk of suicidal thoughts or
actions in some patients, particularly children, adolescents, and young adults. Patients should
be closely monitored for signs of suicidal thoughts or behavior, particularly during the first few
weeks of treatment.
12. Liver Damage
In rare cases, Mirtazapine can cause liver damage. Patients who experience symptoms of liver
damage, such as abdominal pain, jaundice, or dark urine, should contact their healthcare
provider immediately.
13. Allergic Reactions
Some patients may experience allergic reactions while taking Mirtazapine, including rash, hives,
and difficulty breathing. Patients who experience these symptoms should seek medical
attention immediately.
14. Withdrawal Symptoms
Patients who abruptly stop taking Mirtazapine are inclined to have withdrawal symptoms that
can mimic all side effects of the medication.
15. Serotonin Syndrome
Serotonin syndrome is a rare but serious side effect that can occur when there is too much
serotonin in the body. This can happen when taking Mirtazapine in combination with other
medications that affect serotonin levels, such as other antidepressants, migraine medications,
or certain illicit drugs. Symptoms of serotonin syndrome can include agitation, confusion, rapid
heartbeat, high blood pressure, dilated pupils, muscle rigidity, and seizures. Patients who
experience these symptoms should seek medical attention immediately.
16. Hyponatremia
Hyponatremia is a condition in which the blood sodium level becomes too low. This can be a
serious side effect of Mirtazapine, particularly in elderly patients or those with underlying
medical conditions. Symptoms of hyponatremia can include headache, nausea, vomiting,
confusion, seizures, and coma. Patients who experience these symptoms should seek medical
attention immediately.
17. Bone Marrow Suppression
In rare cases, Mirtazapine can cause bone marrow suppression, which can lead to a decrease in
white blood cells, red blood cells, and platelets. This can increase the risk of infection, anemia,
and bleeding. Patients who experience symptoms of bone marrow suppression, such as fatigue,
weakness, fever, or unusual bleeding or bruising, should contact their healthcare provider
immediately.
18. Cardiovascular Effects
Mirtazapine can affect the cardiovascular system, particularly in patients with underlying heart
conditions. It can cause a drop in blood pressure, which can lead to lightheadedness or fainting.
Patients who experience chest pain, shortness of breath, or rapid heartbeat while taking
Mirtazapine should contact their healthcare provider immediately.
19. Respiratory Depression
In rare cases, Mirtazapine can cause respiratory depression, particularly in patients with
underlying respiratory conditions. This can lead to difficulty breathing, decreased oxygen levels,
and even coma. Patients who experience difficulty breathing while taking Mirtazapine should
seek medical attention immediately.
20. Glaucoma
Mirtazapine can cause an increase in intraocular pressure, which can be dangerous for patients
with glaucoma. Patients with a history of glaucoma should be closely monitored while taking
Mirtazapine.
In conclusion, Mirtazapine is a medication that can be effective for treating depression, but it
comes with potential side effects that patients and healthcare providers should be aware of.
Patients who experience any of the above side effects should contact their healthcare provider
immediately to discuss the best course of action. It is important to weigh the benefits and risks
of Mirtazapine with your healthcare provider to determine the best treatment plan for you.
Mark's Story: Mark was prescribed Mirtazapine for his anxiety. He experienced significant weight
gain after starting the medication. Despite maintaining a healthy diet and exercising regularly,
he continued to gain weight. Mark also experienced constipation and had difficulty going to the
bathroom. These side effects impacted his quality of life and he eventually decided to switch to
a different medication.
21. Increased Appetite
Mirtazapine can increase appetite in some patients, which can lead to weight gain. This effect is
thought to be due to the medication's ability to stimulate the release of the hunger hormone,
ghrelin. Patients who experience increased appetite while taking Mirtazapine should discuss this
side effect with their healthcare provider.
22. Insomnia
While Mirtazapine is known for its sedative effects, it can also cause insomnia in some patients.
This is particularly true for patients who take the medication in the morning rather than at
bedtime. Patients who experience insomnia while taking Mirtazapine should talk to their
healthcare provider about adjusting their dosing schedule.
23. Cognitive Impairment
Some patients may experience cognitive impairment while taking Mirtazapine. This can include
difficulty with memory, concentration, and attention. Patients who experience cognitive
impairment while taking Mirtazapine should discuss this side effect with their healthcare
provider.
24. Skin Reactions
Mirtazapine can cause skin reactions in some patients, including rash, hives, and itching. These
side effects are usually mild and can be treated with over-the-counter antihistamines. Patients
who experience severe or persistent skin reactions should seek medical attention immediately.
25. Urinary Retention
Mirtazapine can cause urinary retention in some patients, particularly men with underlying
prostate problems. This can lead to difficulty urinating or even urinary tract infections. Patients
who experience urinary retention while taking Mirtazapine should contact their healthcare
provider immediately.
26. Increased Heart Rate
Mirtazapine can cause an increase in heart rate, particularly in patients with underlying heart
conditions. Patients who experience rapid or irregular heartbeat while taking Mirtazapine
should contact their healthcare provider immediately.
27. Pancreatitis
In rare cases, Mirtazapine can cause inflammation of the pancreas, known as pancreatitis. This
can lead to abdominal pain, nausea, vomiting, and even organ failure. Patients who experience
symptoms of pancreatitis while taking Mirtazapine should seek medical attention immediately.
28. Blood Disorders
Mirtazapine can affect the blood, leading to anemia, leukopenia, or thrombocytopenia. Patients
who experience symptoms of these blood disorders, such as fatigue, weakness, fever, or
unusual bleeding or bruising, should contact their healthcare provider immediately.
29. Severe Allergic Reactions
In rare cases, Mirtazapine can cause severe allergic reactions, including anaphylaxis. Patients
who experience symptoms of anaphylaxis, such as difficulty breathing, swelling of the face or
throat, or hives, should seek medical attention immediately.
30. Interactions with Other Medications
Mirtazapine can interact with other medications, including other antidepressants,
antipsychotics, and certain antibiotics. Patients should inform their healthcare provider of all
medications they are taking, including over-the-counter and herbal supplements, to avoid
potential interactions.
In conclusion, while Mirtazapine can be an effective treatment for depression, it comes with
potential side effects that patients and healthcare providers should be aware of. Patients who
experience any of the above side effects should contact their healthcare provider immediately
to discuss the best course of action. It is important to weigh the benefits and risks of
Mirtazapine with your healthcare provider to determine the best treatment plan for you.
Sarah's Story: Sarah was prescribed Mirtazapine for her depression. She experienced an
increase in appetite and cravings for sweets and carbohydrates. She also felt more lethargic and
had difficulty finding motivation to exercise or engage in other activities. These side effects led
to weight gain and worsened Sarah's depression. She eventually had to switch to a different
medication to manage her symptoms.
31. Tardive Dyskinesia
Tardive dyskinesia is a rare but potentially irreversible side effect of Mirtazapine. It is
characterized by involuntary movements of the face, tongue, and limbs, and can be a result of
long-term use of the medication. Patients who experience symptoms of tardive dyskinesia
should contact their healthcare provider immediately.
32. Withdrawal Syndrome
Patients who abruptly stop taking Mirtazapine can experience withdrawal symptoms, including
nausea, vomiting, headache, dizziness, and irritability. Patients should never abruptly stop
taking Mirtazapine and should work with their healthcare provider to gradually taper off the
medication.
33. Decreased Blood Pressure
Mirtazapine can cause a decrease in blood pressure, particularly in patients with underlying
heart conditions. Patients who experience symptoms of low blood pressure, such as dizziness
or lightheadedness, should contact their healthcare provider immediately.
34. Mania/Hypomania
In rare cases, Mirtazapine can cause manic or hypomanic episodes, particularly in patients with
underlying bipolar disorder. Patients who experience symptoms of mania or hypomania, such
as elevated mood, increased energy, and decreased need for sleep, should contact their
healthcare provider immediately.
35. Hypermotility Syndrome Mirtazapine can cause hypermotility syndrome, which is
characterized by diarrhea, abdominal cramping, and fever. Patients who experience symptoms
of hypermotility syndrome should contact their healthcare provider immediately.
36. Worsening of Depression or Anxiety
While Mirtazapine is an effective treatment for depression and anxiety, in rare cases it can
worsen symptoms of these disorders. Patients who experience a worsening of depression or
anxiety while taking Mirtazapine should contact their healthcare provider immediately.
37. Abnormal Dreams
Some patients may experience abnormal dreams while taking Mirtazapine. This side effect is
usually mild and does not require medical attention.
38. Visual Changes
Mirtazapine can cause visual changes in some patients, including blurred vision and difficulty
focusing. Patients who experience these symptoms should contact their healthcare provider.
39. Renal Impairment
Mirtazapine can cause renal impairment in some patients, particularly those with underlying
kidney problems. Patients who experience symptoms of renal impairment, such as decreased
urine output or swelling of the legs, should contact their healthcare provider immediately.
40. Cognitive Behavioral Changes
Mirtazapine can cause cognitive and behavioral changes in some patients, including confusion,
agitation, and hallucinations. Patients who experience these symptoms should contact their
healthcare provider immediately.
In summary, while Mirtazapine can be an effective treatment for depression and anxiety, it
comes with a range of potential side effects. Patients and healthcare providers should be aware
of these side effects and monitor patients closely for any signs of adverse reactions. Patients
who experience any of the above side effects should contact their healthcare provider
immediately to discuss the best course of action.
John's Story: John was prescribed Mirtazapine for his insomnia. While the medication helped
him fall asleep faster, he experienced vivid nightmares and sleep paralysis. These side effects
left John feeling exhausted and anxious during the day. He eventually switched to a different
medication that did not cause these side effects.
41. Neurological Symptoms
Mirtazapine can cause neurological symptoms in some patients, including tremors, seizures,
and extrapyramidal symptoms (EPS). EPS are a group of movement disorders that can include
dystonia, akathisia, and tardive dyskinesia. Patients who experience neurological symptoms
while taking Mirtazapine should contact their healthcare provider immediately.
42. Respiratory Tract Infection
Mirtazapine can increase the risk of respiratory tract infections, such as pneumonia or
bronchitis. Patients who experience symptoms of a respiratory tract infection, such as coughing,
chest pain, or shortness of breath, should contact their healthcare provider immediately.
43. Gastrointestinal Bleeding
In rare cases, Mirtazapine can cause gastrointestinal bleeding, which can be life-threatening.
Patients who experience symptoms of gastrointestinal bleeding, such as vomiting blood or
passing black, tarry stools, should seek medical attention immediately.
44. Cardiovascular Events
Mirtazapine can increase the risk of cardiovascular events, such as heart attack or stroke.
Patients with underlying heart conditions or risk factors for cardiovascular disease should be
closely monitored while taking Mirtazapine.
45. Hepatitis
Mirtazapine can cause hepatitis, which is inflammation of the liver. Patients who experience
symptoms of hepatitis, such as yellowing of the skin or eyes, dark urine, or abdominal pain,
should contact their healthcare provider immediately.
46. Increased Risk of Falls
Mirtazapine can increase the risk of falls, particularly in elderly patients or those with underlying
balance problems. Patients should use caution when performing activities that require
coordination or balance, such as walking or climbing stairs.
47. Stevens-Johnson Syndrome
Stevens-Johnson syndrome is a rare but serious skin reaction that can occur while taking
Mirtazapine. It is characterized by a severe rash, blisters, and peeling of the skin. Patients who
experience symptoms of Stevens-Johnson syndrome should seek medical attention
immediately.
48. Hypersensitivity Reactions
Some patients may experience hypersensitivity reactions while taking Mirtazapine, including
angioedema, anaphylaxis, or urticaria. Patients who experience symptoms of a hypersensitivity
reaction, such as swelling of the face or throat, difficulty breathing, or hives, should seek
medical attention immediately.
49. Galactorrhea
Mirtazapine can cause galactorrhea, which is the production of breast milk in non-pregnant or
non-nursing women. Patients who experience galactorrhea while taking Mirtazapine should
contact their healthcare provider.
50. Teratogenicity
Mirtazapine can be teratogenic, meaning it can cause harm to a developing fetus. Patients who
are pregnant or planning to become pregnant should discuss the risks and benefits of taking
Mirtazapine with their healthcare provider.
In conclusion, Mirtazapine is a medication that can be effective for treating depression and
anxiety, but it comes with potential side effects that patients and healthcare providers should be
aware of. Patients who experience any of the above side effects should contact their healthcare
provider immediately to discuss the best course of action. It is important to weigh the benefits
and risks of Mirtazapine with your healthcare provider to determine the best treatment plan for
you.
Remeron Mirtazapine
Side Effects